Risk stratification model for incidentally detected gallbladder polyps: A multicentre study.

Area of Science:

• Gastroenterology
• Diagnostic Imaging
• Oncology

Background:

• Gallbladder polyps are common findings, but differentiating between neoplastic and malignant types can be challenging.
• Accurate risk stratification is crucial for determining appropriate management and preventing progression to malignancy.

Purpose of the Study:

• To develop and validate a 4-level risk stratification model for gallbladder polyps using conventional ultrasound.
• To enhance the diagnostic accuracy of gallbladder polyps through a novel scoring system.

Main Methods:

• A risk stratification system was developed using ultrasound findings and clinical characteristics from 370 patients with confirmed gallbladder polyps.
• The model was trained retrospectively on 264 samples and validated prospectively on 106 samples.
• Performance was assessed using the area under the receiver operating characteristic curve (AUC) and malignancy rates.

Main Results:

• Key risk factors for neoplastic polyps included size (≥12 mm), shape, single presence, vascularity, and gallbladder stones/sludge.
• Risk factors for malignant polyps included size (≥14 mm), shape, single presence, disrupted gallbladder wall, and gallbladder stones/sludge.
• The model demonstrated high performance, with AUCs of 0.876 for neoplastic and 0.949 for malignant polyps, and malignancy rates ranging from 0% to 70.37% across the four risk levels.

Conclusions:

• The developed 4-level risk stratification model based on conventional ultrasound shows excellent performance.
• This model offers a valuable tool for improving the classification and management of gallbladder polyps.